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Case:Smoke
Smoke began showing the signs of feline diabetes mellitus in early May 2006, although I didn't know what I was looking at or connecting the symptoms. It began when she wouldn't play very frequently; however, she would come upstairs to the "cat" room to be near Santana and I when Santana wanted to play "pounce on the cat charmer" and "chase Da Bird". Shortly after that, I saw her drinking water more frequently. Unfortunately, I was home more often than I used to be so I thought I was just "catching her in the act" regularly. From there, I noticed that the litter boxes were filling up frequently with voluminous urine. This didn't ring any bells with me, so I just started cleaning them twice a day. At the beginning of June, I looked at Smoke and thought that she might have lost weight, but my other cat looked heftier, so I wasn't certain. A week later (on a Friday night, of course), I picked her up and really started to LOOK at her. I could feel her backbone and she was definitely thinner. I planned to take her to the vet the following week at some point. On Sunday, June 11th, I found urine outside the litterbox with blood in in. I decided I would take her to the vet the first thing Monday morning. Later in the evening, she began running around the house, trying to urinate behind the TV, in the hallway, in the half-bath... so I knew she had to go right in. We went to the emergency vet where it was determined that in addition to a UTI, she also had glucose in her urine and was "a bit ketotic". The emergency vet suggested that I bring her to the normal vet for evaluation. If I had known that "a bit ketotic" was dangerous, I would have (and should have) insisted upon agressive treatment at that time. On Monday, June 12th, I called the vet and they asked me to bring her in on the morning of June 13th. She spent that Tuesday at the vet receiving fluids and insulin. The vet told me that they were treating her for ketones and would continue to do so the next 2 days. I brought her home for the night (because they weren't a 24 hour facility), with the plan of bringing her back the following day. She didn't have a good night and on Wednesday morning, I couldn't find her. She wouldn't come no matter how long I called her and after 20 minutes of fruitless searching, I thought for sure she had embedded herself somewhere to die and that I was looking for a kitty corpse. Eventually I found her, lying under a blanket in a box... alive. I brought her back to the vet for another day of treatment. The vet called me at 9:30 AM to tell me that Smoke was in full Diabetic Ketoacidosis (DKa). I was given the option of putting her to sleep or taking her to the emergency vet for around-the-clock treatment with a minimum cost of $1,600. I decided to treat. I picked Smoke up and drove her over to the emergency/urgent care vet, where she spent 4.5 days receiving fluids, electrolytes, infusion insulin and a bolus of antibiotics 3x/day. She didn't eat for 4 days until I poached salmon and shrimp for her at 5 AM on Saturday morning (June 17th) and brought that to the emergency vet for her. I was told I could pick her up on Sunday, June 18th at 3:30 PM. Prior to picking her up, I bought a glucometer, test strips, lancets, ketostix and a large supply of wet low-carb canned food. I determined to home-test her blood glucose levels and continually monitor her for ketones. That evening, I tested Smoke for the first time and gave her the first shot of Vetsulin insulin. I found the Feline Diabetes Message Board, which was the best thing that could have happened to Smoke and I. The vet had prescribed 1 unit of Vetsulin every 12 hours. The first night was the last night I followed that instruction. I also went against 2 vets' recommendations by hometesting with a glucometer. If you follow the link to more of my case history, you'll see that I monitored the insulin's affect on Smoke very closely for the first 10 days - which led to her first round of "remission" (or, as I call it, diet control). On 7/2, Smoke, after 4 days without insulin, got into less than 1 ounce of dry food, which immediately took her blood glucose levels into the high 300's and low 400's. Given her history of DKA, I treated that aggressively with insulin and 4 days later, she was in her second round of "remission" (diet control), which continues until this day. I do test Smoke's blood glucose a minimum of once a day, but sometimes more if I notice that she's sleeping a lot or if she's getting secretions from her eyes - because that was another one of the symptoms I noticed but didn't think about. I will continue to stay on top of her health. Some people think that feline diabetes is a death sentence. I view it as a gift. I am closer with both of my cats now (although we were always close). I spend a lot more time focused on both cats and do not take the love they give me for granted. I would counsel anyone who has a cat diagnosed with diabetes to treat. To watch my little cat, who was losing weight and lethargic, running around stalking critters from her porch and digging into a big bowl of grilled chicken makes the entire experience that much more rewarding. If I had chosen not to treat, she would no longer be with me. Instead, she climbs up on me at night and sleeps soundly and enjoys every day. It's the best feeling! 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